Called Afrezza, the rapid-acting insulin is taken before each meal, or not long after beginning to eat, with no needles required. Afrezza will not replace the requirement for injected long-acting insulin for those who require it, however.
How is Afrezza various than other insulin?
Due to the fact that it’s inhaled, it’s soaked up faster and in a different method.
“Afrezza is quickly absorbed from the cells in the lungs [to the blood stream],” states R. Keith Campbell, RPh. He’s a licensed diabetes educator and distinguished teacher emeritus in diabetes care and pharmacotherapy at Washington State University College of Pharmacy. He has actually studied the drug however has no ties to its designer.
“From the time you inhale it to the time it really peaks [in the blood] is 15 to 20 minutes,” Campbell says. Injected insulin taken prior to a meal, he states, takes about an hour to peak.
The body also clears Afrezza quicker than insulin injected at mealtime, states Bruce Bode, MD. He’s a diabetes expert in Atlanta who did a medical trial funded by MannKind Corporation, the drug’s developer.
Besides its fast peak, the drug is “basically gone in 2 or 3 hours,” Bode says. Rapid-acting injected insulins, he says, typically “hang around for about 4 hours. Afrezza is fast in, quick out. It is emulating, in essence, what the pancreas does.”
How is it taken?
Users position a dosage of Afrezza, in powder kind, into a small, whistle-sized inhaler. Dosages can be found in a cartridge, and each cartridge contains a single dosage.
How does Afrezza work compared with rapid-acting injected insulins?
In a 24-week research study, Bode compared Afrezza with a rapid-acting, injected insulin in more than 500 patients with type 1 diabetes. Afrezza and injected insulin controlled blood sugar level similarly well, he says. But he discovered that those using Afrezza were less most likely to get extremely low blood sugar level, an issue of insulin use.
With Afrezza, “there is also less weight gain,” Bode says. He credits that to the shorter time Afrezza stays in the body.
In another research study, researchers discovered that people with type 2 diabetes who weren’t getting sufficient control of blood glucose with oral medications did much better when they added breathed in insulin prior to meals.
Both studies were presented at the American Diabetes Association conference in June.
The FDA approved Afrezza’s safety and efficiency based upon about 3,000 individuals, consisting of 1,000 with type 1 diabetes and about 2,000 with type 2.
What about side effects?
In the Afrezza clinical trials, the most frequently reported side effects were low blood sugar, cough, and throat pain or irritation, inning accordance with the FDA.
The drug will carry a caution that it could cause sudden tightening up of the chest, referred to as severe bronchospasm.
It is not suggested for people with asthma or COPD, or in cigarette smokers. It isn’t recommended to treat diabetic ketoacidosis, a serious issue when the body makes high levels of blood acids known as ketones.
The FDA is likewise needing more research study to examine the prospective risk of lung cancer.
Is this a game-changer for individuals with diabetes?
Some specialists think so, however others are taking a wait-and-see method.
“I think it is,” Campbell states. He states the inhaler for Afrezza is much better designed and easier to use than a more cumbersome one used with another breathed in insulin, Exubera, he says.
Exubera was approved by the FDA in 2006 but withdrawn from the marketplace by its maker, Pfizer, in 2007, in part due to low sales.
Health care companies had to invest a half hour approximately simply to discuss how to use the Exubera inhaler, Campbell states. The Afrezza inhaler, he says, “is really little, simple to use, and it takes less than a minute to train a patient how to use the insulin.”
Marie McDonnell, MD, director of the Brigham Diabetes Program at Brigham and Women’s Hospital, states Afrezza has pledge if “we can reveal there is no risk to the lung tissue and the mouth and esophagus.”
“It works much faster than both of the injected insulins we have now, the regular and the rapid-acting,” she states. “This might indicate you will need less insulin [total] to get the exact same results.” And that may reduce the weight gain that frequently happens in brand-new users, she states.
She plans to prescribe it, but on a case-by-case basis.
George King, MD, primary clinical officer at Joslin Diabetes Center, states it might be helpful for some. “I think inhaled insulin would benefit people who are really averse to needles,” he states. However he estimates only 10% or 15% of people on insulin fit that classification.
What will it cost?
“Our expectation is it ought to be priced comparably to existing fast-acting [injected] insulins delivered in pen kind,” states Matthew Pfeffer, a MannKind spokesperson.
Prices for the fast-acting insulin pens vary. One popular fast-acting pen insulin costs about $270 a month, without insurance protection, for an individual who requires 30 systems a day, a common amount.
When will it be available?
As of Feb. 3, 2015, Afrezza was available by prescription in U.S. retail drug stores, inning accordance with MannKind.